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User
Posted 06 May 2018 at 13:23

I have read with interest on this website about the pros and cons of having a PSA test  https://prostatecanceruk.org/media/2343617/psa_leaflet-ifm.pdf

and a biopsy: https://prostatecanceruk.org/prostate-information/prostate-tests/prostate-biopsy

and I have read about the Cancer Research UK 10 year study that concludes " a one-off PSA test for prostate cancer is doing men more harm than good"

http://scienceblog.cancerresearchuk.org/2018/03/06/why-a-one-off-psa-test-for-prostate-cancer-is-doing-men-more-harm-than-good/

 

Now reading this about breast cancer screening http://www.bbc.co.uk/news/health-44016206

 

My concern is that I am in danger of being "over diagnosed" and having a load of unnecessary treatment done

 

Any thoughts anyone? 

 

User
Posted 20 May 2018 at 17:18

I think it is Chris J whose brother has never been tested despite being a doctor and having a brother diagnosed in his 40s.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 06 May 2018 at 18:33
Hi Lazarus

I love the statement that 'for men with no symptoms the PSA test doesn't save lives'.

I had no symptoms but the PSA test suggested that something could be amiss and so it triggered further investigations. The end result was a Gleason 9 T3b which I think might have had an effect on my life expectancy if left untreated. The PSA test is only an indicator and as far as I know nobody gets treated just as a result of one PSA test as it doesn't offer a diagnosis of anything.

User
Posted 06 May 2018 at 21:38

I think Kevan was being ironic?

Lazarus, in your early posts you said that even if you got the all clear you would still be convinced that you have an undiagnosed cancer raging around your body. If you don't have the further tests, the possibility is that you will regret it and your nights will be filled with nightmares and real or imagined pain. You are not being over-tested on the basis of one PSA test - in your case, there is an indeterminate shadow on your prostate which needs checking out.

Over-treatment is not the same as over-testing; there is some concern internationally about the number of men being treated for low grade prostate cancer (ie. G6 or sometimes G7(3+4) that would never have harmed them. The same debate is going on about the over-treatment of low grade breast cancer (as a result of which, women get a leaflet in the post with their mammogram reminder, explaining the risks of over-diagnosis and false positives). However, that doesn't mean that those men shouldn't have diagnostic tests - if indeed you are diagnosed with prostate cancer, that will be the time to start debating whether you should have radical treatment or active surveillance.

Edited by member 06 May 2018 at 21:39  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 07 May 2018 at 11:33

I wouldn't even consider what to do, until your biopsy results are in. It's all guesswork until then. You will be given considered options at that time, I hope watching and waiting is one of them.
Don't rush ahead and get overthinking it.

User
Posted 07 May 2018 at 20:11
Hi Lazarus

Thanks for the good wishes and just to confirm that my situation is pretty good thanks to that first PSA test.

There is a process to go through and as the others have said, once you have all of the test results then you discuss what (if anything) needs to be done.

In my case because the PCa was deemed to be aggressive we decided that it needed to be treated. I had the operation, followed by salvage RT and am now on HT and doing fine.

Life is good and I know how lucky I have been.

I think you are doing the right thing by ensuring that you do what you feel is right for you.

All the best to you.

User
Posted 19 May 2018 at 14:19

Hi Lazarus,

I've just been reading your post and the answers you have received, all have good advice for you, LynEyre is always very good as is the advice from TyKey.

However I just thought I would share my situation with you to show how testing can have benefits. I had a routine blood test last October which showed an elevated PSA and that it had doubled since my last blood test. My GP decided to give me a DRE (digital rectal exam) and because of what she found referred me to my local hospital. They then did another DRE and said they believed I had Cancer, I was then given an MRI followed by a biopsy, as the MRI was inconclusive. The results showed that I did indeed have cancer and my urologist then said that due to the type of cancer I would be put on active watch. However after the oncologist looked at the results she said that I required treatment because I had two tumors one a 3+3 the other a 4+3 the 4+3 was the one which concerned her the most as it was very close to the wall of the prostate, her worry was that it could break out from the prostate and become much worse. She then proceeded to advise me on treatment options. I went to see various specialists for each of the treatment types and after a month or so of appointments and discussions with my wife and family decided on surgery.

My friend. on the other hand, had an elevated PSA when he was tested which was much higher than mine, however it turned out that he had a slightly enlarged prostate and a water infection, he was treated with antibiotics and a few months later his PSA had reduced significantly. As a precaution he underwent a biopsy that came back negative after that he was given tablets which helped to reduce the swelling in the prostate and eased his nightly trips to the loo.

My point is that we are all different there is no singular path, a high PSA does not always lead to a cancer diagnosis it could be a sign of infection, MRI scans are not always the most effective in determining cancer either, the technology just isn't there yet. Unfortunately a biopsy, at the moment, is probably the only real way to determine cancer, well it was for me. Hopefully for you it will come back negative and you won't have to worry about treatment options etc.

Like you I was very down and confused but with the help and support of my family and friends and the wonderful people on this website my life began to get better.

I hope everything works out for you

best of luck

Ants

User
Posted 19 May 2018 at 14:49

I don't think there are any easy answers here, Lazarus. I have no symptoms, but because I'm 55 my GP suggested a PSA test which came back with a result of 31, which is definitely "cause for concern". I've had an MRI scan (which, interestingly, showed no prostate abnormality) and I've just had a biopsy, the result of which I'll get in a little under two weeks. Even if it does all come back negative, I'll still be happy that I've had the investigations done, and if (as seems much more likely) the result is positive, I'll be even more happy that I know about it and can get the appropriate treatment. I'm definitely not a supporter of the "ignorance is bliss" point of view, and I really wish that there was a national screening programme in place. The way things are now, an awful lot of men only get diagnosed with prostate cancer when it's reached an advanced stage and symptoms show up!

Chris

 

Edited by member 19 May 2018 at 14:51  | Reason: Not specified

User
Posted 19 May 2018 at 17:49

Originally Posted by: Online Community Member

Hi Lazarus,

I've just been reading your post and the answers you have received, all have good advice for you, LynEyre is always very good as is the advice from TyKey.

However I just thought I would share my situation with you to show how testing can have benefits. I had a routine blood test last October which showed an elevated PSA and that it had doubled since my last blood test. My GP decided to give me a DRE (digital rectal exam) and because of what she found referred me to my local hospital. They then did another DRE and said they believed I had Cancer, I was then given an MRI followed by a biopsy, as the MRI was inconclusive. The results showed that I did indeed have cancer and my urologist then said that due to the type of cancer I would be put on active watch. However after the oncologist looked at the results she said that I required treatment because I had two tumors one a 3+3 the other a 4+3 the 4+3 was the one which concerned her the most as it was very close to the wall of the prostate, her worry was that it could break out from the prostate and become much worse. She then proceeded to advise me on treatment options. I went to see various specialists for each of the treatment types and after a month or so of appointments and discussions with my wife and family decided on surgery.

My friend. on the other hand, had an elevated PSA when he was tested which was much higher than mine, however it turned out that he had a slightly enlarged prostate and a water infection, he was treated with antibiotics and a few months later his PSA had reduced significantly. As a precaution he underwent a biopsy that came back negative after that he was given tablets which helped to reduce the swelling in the prostate and eased his nightly trips to the loo.

My point is that we are all different there is no singular path, a high PSA does not always lead to a cancer diagnosis it could be a sign of infection, MRI scans are not always the most effective in determining cancer either, the technology just isn't there yet. Unfortunately a biopsy, at the moment, is probably the only real way to determine cancer, well it was for me. Hopefully for you it will come back negative and you won't have to worry about treatment options etc.

Like you I was very down and confused but with the help and support of my family and friends and the wonderful people on this website my life began to get better.

I hope everything works out for you

best of luck

Ants

 

Thanks for that Ants - I appreciate it.

Like you I am grateful for all the support I have received from everyone on this forum and for all the information on the website.

I'm due have my biopsy on the 5th June and get my results on the 12th June.

I'm hoping for a clear result where the decision with regards to the next step will also be clear as I'm not the greatest at making decisions at the best of times and it is all the uncertainty that has played with my mind and got me down.

All the best to you and I hope that things continue to get better for you.

 

User
Posted 19 May 2018 at 19:00

Hi Lazarus,

I understand and share your anxiety, been there done that. And I hope that your results are clear for you.

Your paragraph 2 is only worth nothing for the men in that test sample.

Hopefully No Man Over 50 With No Symptoms Reading That Will Be Deterred From Having A Test

What would you say to those men over 50, without symptoms, diagnosed, who's lives are saved and lengthened as a result of a PSA test?

Any man, or any partner of any man reading this should consider whether having a PSA test is for them or not, not based on some random sample of others.

Do let us know your results. Have a great weekend.

dave

User
Posted 19 May 2018 at 19:15

The point is, Lazarus, that if a man is diagnosed with prostate cancer, he can then make an informed decision whether or not to have treatment, and a high PSA score can often lead to such a diagnosis. Without a test, he may very well be unaware that he has cancer, and that choice is denied him. Don't confuse testing with treatment!

Best wishes,

Chris

User
Posted 20 May 2018 at 15:30

I am in the pub with a friend who is 68 whose father died of prostate cancer who has never had a PSA test or a DRE!

Another friend is here aged 75 with a PSA of 2.2, and recently was offered a DRE and a lump was found. Three weeks later, he has had an MRI, biopsy and cancer diagnosis.

They like me, are asymptomatic

Edited by member 21 May 2018 at 13:17  | Reason: Not specified

User
Posted 21 May 2018 at 20:10

When John was diagnosed, the surgeon advised that we take a short pause, go off on a holiday and do lots of 'what couples do." Unfortunately John was in a dreadful hurry to get it cut out and did not heed the advice, having his RP 26 days later.

In the horrible months and years after, we both said how nice it would have been to have had a lovely holiday and some happy things to look back on when we were struggling with the new normal.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 May 2018 at 20:50

That’s a nice post Lyn in a way. I spent so much time doing what couples do , that I missed the boat essentially. Epic fail surgery , and now after taking over 2 years to recover , I’m still preferring doing what couples do ! Maybe John was right as you are still firmly in the long term remission camp and enjoying life more than some people waiting on every appointment. Oh , and dancing a lot :-)) x

User
Posted 21 May 2018 at 21:19

Not much dancing going on at the minute - his two new knees are cramping my style rather a lot :-(

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 May 2018 at 23:12

What bit of it is inaccurate or misleading CB? It has been quoted very precisely and, whether you like it or not, is exactly what the researchers concluded and NICE have positioned themselves on.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

Show Most Thanked Posts
User
Posted 06 May 2018 at 18:33
Hi Lazarus

I love the statement that 'for men with no symptoms the PSA test doesn't save lives'.

I had no symptoms but the PSA test suggested that something could be amiss and so it triggered further investigations. The end result was a Gleason 9 T3b which I think might have had an effect on my life expectancy if left untreated. The PSA test is only an indicator and as far as I know nobody gets treated just as a result of one PSA test as it doesn't offer a diagnosis of anything.

User
Posted 06 May 2018 at 21:05

Originally Posted by: Online Community Member
Hi Lazarus
I love the statement that 'for men with no symptoms the PSA test doesn't save lives'.
I had no symptoms but the PSA test suggested that something could be amiss and so it triggered further investigations. The end result was a Gleason 9 T3b which I think might have had an effect on my life expectancy if left untreated. The PSA test is only an indicator and as far as I know nobody gets treated just as a result of one PSA test as it doesn't offer a diagnosis of anything.

 

Unlike Kevin, I loathe that statement, as it is inaccurate in his case and mine.  May be accurate for others? Toss that coin.

I had zero symptoms, only 55 on diagnosis, but I had an originally graded T2b cancer in me, upgraded to T3 on pathology.

Schools of thought.  What you don't know can't hurt you?  Or maybe, what you really don't know may be hurting you more than you care to imagine?

Anybody's one PSA may not be definitive, but a series of your PSA tests may be accurately indicative for you?  

atb

dave

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

User
Posted 06 May 2018 at 21:38

I think Kevan was being ironic?

Lazarus, in your early posts you said that even if you got the all clear you would still be convinced that you have an undiagnosed cancer raging around your body. If you don't have the further tests, the possibility is that you will regret it and your nights will be filled with nightmares and real or imagined pain. You are not being over-tested on the basis of one PSA test - in your case, there is an indeterminate shadow on your prostate which needs checking out.

Over-treatment is not the same as over-testing; there is some concern internationally about the number of men being treated for low grade prostate cancer (ie. G6 or sometimes G7(3+4) that would never have harmed them. The same debate is going on about the over-treatment of low grade breast cancer (as a result of which, women get a leaflet in the post with their mammogram reminder, explaining the risks of over-diagnosis and false positives). However, that doesn't mean that those men shouldn't have diagnostic tests - if indeed you are diagnosed with prostate cancer, that will be the time to start debating whether you should have radical treatment or active surveillance.

Edited by member 06 May 2018 at 21:39  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 06 May 2018 at 23:04

I can see whoever represents PCUK at the Mill next month getting a bit of an 'ear lashing'!

(Panic at the moment over women not being sent mammogram notifications - lives shortened claims - urgent appointments and processing in train! )

Barry
User
Posted 07 May 2018 at 10:41

Originally Posted by: Online Community Member

I think Kevan was being ironic?

Lazarus, in your early posts you said that even if you got the all clear you would still be convinced that you have an undiagnosed cancer raging around your body. If you don't have the further tests, the possibility is that you will regret it and your nights will be filled with nightmares and real or imagined pain. You are not being over-tested on the basis of one PSA test - in your case, there is an indeterminate shadow on your prostate which needs checking out.

Over-treatment is not the same as over-testing; there is some concern internationally about the number of men being treated for low grade prostate cancer (ie. G6 or sometimes G7(3+4) that would never have harmed them. The same debate is going on about the over-treatment of low grade breast cancer (as a result of which, women get a leaflet in the post with their mammogram reminder, explaining the risks of over-diagnosis and false positives). However, that doesn't mean that those men shouldn't have diagnostic tests - if indeed you are diagnosed with prostate cancer, that will be the time to start debating whether you should have radical treatment or active surveillance.

Thanks Lyn

I am going to do what you suggest and go for the transperineal biopsy on the 5th June and get the results on the 12th June and then consider my options then. Once I have the results from the biopsy I can then hopefully make an informed decision as to whether to go for treatment or not.

I'm beginning to realise that because I am quite depressed and low in mood I have become extremely anxious about all of this and that what I need to do is discount how I am feeling and try to be more analytical in my approach.

It's just that it does seem to me now that due to a degree of panic on my part and over diagnosis on the medical part that I could find myself having treatment for something that I don't really need.

I won't know however where I stand however until I have had the results of the biopsy - maybe it will be a case of "Good news you don't have cancer" or maybe it will be a case of " it's a good job we found it because I'm afraid you've got the really bad kind of cancer it's a a real tiger that needs urgent treatment to save your life" or maybe it's going to be a case of "well you have got cancer but as it looks like a pussycat one you might want to consider opting for active surveillance at this stage rather than surgery or radiotherapy"

If it's the last one then based on what I have read about the dangers of "over diagnosis" in relation to both prostate cancer and breast cancer. I'm definitely going to opt for the active surveillance rather than treatment. 

According to the guy who set up the NHS breast screening program 20 years ago: Michael Baum, professor emeritus of surgery at University College London - 

"Harms from breast cancer screening outweigh benefits if death caused by treatment is included"

https://www.bmj.com/content/346/bmj.f385

And the same man makes his case against breast screening in the Daily Mail: 'I set up breast cancer screening - now I'm it's biggest critic': Top doctor argues why mammograms 'do more harm than good'

Read more: http://www.dailymail.co.uk/health/article-3474455/I-set-breast-cancer-screening-m-s-biggest-critic-doctor-argues-mammograms-harm-good.html#ixzz5EoFTxPHs 

Reading these has certainly made me think that I probably won't opt for treatment unless it is absolutely certain that I really need it.

 

Edited by member 07 May 2018 at 11:38  | Reason: Not specified

User
Posted 07 May 2018 at 11:33

I wouldn't even consider what to do, until your biopsy results are in. It's all guesswork until then. You will be given considered options at that time, I hope watching and waiting is one of them.
Don't rush ahead and get overthinking it.

User
Posted 07 May 2018 at 17:50

Originally Posted by: Online Community Member
Hi Lazarus
I love the statement that 'for men with no symptoms the PSA test doesn't save lives'.
I had no symptoms but the PSA test suggested that something could be amiss and so it triggered further investigations. The end result was a Gleason 9 T3b which I think might have had an effect on my life expectancy if left untreated. The PSA test is only an indicator and as far as I know nobody gets treated just as a result of one PSA test as it doesn't offer a diagnosis of anything.

I'm new to all this so I don't yet understand all the medical terminology but from your post guessing your cancer is a bad one.

Good for you that you had the PSA test done as with no symptoms you wouldn't had known you had cancer until it started to hurt.

All the best to you and thanks for your input.

I can understand why screening for PCa using via the PSA blood test is so controversial - for some it can lead to an early diagnosis that could be literally a lifesaver but for others it could lead to unnecessary treatment for a cancer that would not have bothered them anyway. 

My GP told me in 2011 when I had my first PSA test done aged 45 a couple of years after my brother was diagnosed with it aged 56, (he's on the active surveillance) that the majority of men die with PCa not from it - she told me not to worry about it as that what with my PSA score being just 1.2 at the time I was considered a low risk in spite of my urinary problems and my family history.

I relaxed myself hearing that but fast forward 7 years to 2018 and now I am 52 years old with two PSA readings this year one of 6.5 and another of 4.5 and a lesion on my prostate showing up on the MRI scan giving it an indeterminate score of 3 and a recomendation for a transperineal template biopsy on the 5th June.

Seeing as it's life and death stuff we're discussing it's an emotional thing to discuss.

I don't know anything about your situation but I hope you're getting the very best medical care.

I just don't want to end up having a medical intervention that is not strictly necessary - I guess I have to wait and see what the doctor says after they look at my biopsy results and hope I get a clear indication as to what I should do when I get told the results on the 12th June.

 

Edited by member 07 May 2018 at 18:03  | Reason: Not specified

User
Posted 07 May 2018 at 20:11
Hi Lazarus

Thanks for the good wishes and just to confirm that my situation is pretty good thanks to that first PSA test.

There is a process to go through and as the others have said, once you have all of the test results then you discuss what (if anything) needs to be done.

In my case because the PCa was deemed to be aggressive we decided that it needed to be treated. I had the operation, followed by salvage RT and am now on HT and doing fine.

Life is good and I know how lucky I have been.

I think you are doing the right thing by ensuring that you do what you feel is right for you.

All the best to you.

User
Posted 19 May 2018 at 14:19

Hi Lazarus,

I've just been reading your post and the answers you have received, all have good advice for you, LynEyre is always very good as is the advice from TyKey.

However I just thought I would share my situation with you to show how testing can have benefits. I had a routine blood test last October which showed an elevated PSA and that it had doubled since my last blood test. My GP decided to give me a DRE (digital rectal exam) and because of what she found referred me to my local hospital. They then did another DRE and said they believed I had Cancer, I was then given an MRI followed by a biopsy, as the MRI was inconclusive. The results showed that I did indeed have cancer and my urologist then said that due to the type of cancer I would be put on active watch. However after the oncologist looked at the results she said that I required treatment because I had two tumors one a 3+3 the other a 4+3 the 4+3 was the one which concerned her the most as it was very close to the wall of the prostate, her worry was that it could break out from the prostate and become much worse. She then proceeded to advise me on treatment options. I went to see various specialists for each of the treatment types and after a month or so of appointments and discussions with my wife and family decided on surgery.

My friend. on the other hand, had an elevated PSA when he was tested which was much higher than mine, however it turned out that he had a slightly enlarged prostate and a water infection, he was treated with antibiotics and a few months later his PSA had reduced significantly. As a precaution he underwent a biopsy that came back negative after that he was given tablets which helped to reduce the swelling in the prostate and eased his nightly trips to the loo.

My point is that we are all different there is no singular path, a high PSA does not always lead to a cancer diagnosis it could be a sign of infection, MRI scans are not always the most effective in determining cancer either, the technology just isn't there yet. Unfortunately a biopsy, at the moment, is probably the only real way to determine cancer, well it was for me. Hopefully for you it will come back negative and you won't have to worry about treatment options etc.

Like you I was very down and confused but with the help and support of my family and friends and the wonderful people on this website my life began to get better.

I hope everything works out for you

best of luck

Ants

User
Posted 19 May 2018 at 14:49

I don't think there are any easy answers here, Lazarus. I have no symptoms, but because I'm 55 my GP suggested a PSA test which came back with a result of 31, which is definitely "cause for concern". I've had an MRI scan (which, interestingly, showed no prostate abnormality) and I've just had a biopsy, the result of which I'll get in a little under two weeks. Even if it does all come back negative, I'll still be happy that I've had the investigations done, and if (as seems much more likely) the result is positive, I'll be even more happy that I know about it and can get the appropriate treatment. I'm definitely not a supporter of the "ignorance is bliss" point of view, and I really wish that there was a national screening programme in place. The way things are now, an awful lot of men only get diagnosed with prostate cancer when it's reached an advanced stage and symptoms show up!

Chris

 

Edited by member 19 May 2018 at 14:51  | Reason: Not specified

User
Posted 19 May 2018 at 17:49

Originally Posted by: Online Community Member

Hi Lazarus,

I've just been reading your post and the answers you have received, all have good advice for you, LynEyre is always very good as is the advice from TyKey.

However I just thought I would share my situation with you to show how testing can have benefits. I had a routine blood test last October which showed an elevated PSA and that it had doubled since my last blood test. My GP decided to give me a DRE (digital rectal exam) and because of what she found referred me to my local hospital. They then did another DRE and said they believed I had Cancer, I was then given an MRI followed by a biopsy, as the MRI was inconclusive. The results showed that I did indeed have cancer and my urologist then said that due to the type of cancer I would be put on active watch. However after the oncologist looked at the results she said that I required treatment because I had two tumors one a 3+3 the other a 4+3 the 4+3 was the one which concerned her the most as it was very close to the wall of the prostate, her worry was that it could break out from the prostate and become much worse. She then proceeded to advise me on treatment options. I went to see various specialists for each of the treatment types and after a month or so of appointments and discussions with my wife and family decided on surgery.

My friend. on the other hand, had an elevated PSA when he was tested which was much higher than mine, however it turned out that he had a slightly enlarged prostate and a water infection, he was treated with antibiotics and a few months later his PSA had reduced significantly. As a precaution he underwent a biopsy that came back negative after that he was given tablets which helped to reduce the swelling in the prostate and eased his nightly trips to the loo.

My point is that we are all different there is no singular path, a high PSA does not always lead to a cancer diagnosis it could be a sign of infection, MRI scans are not always the most effective in determining cancer either, the technology just isn't there yet. Unfortunately a biopsy, at the moment, is probably the only real way to determine cancer, well it was for me. Hopefully for you it will come back negative and you won't have to worry about treatment options etc.

Like you I was very down and confused but with the help and support of my family and friends and the wonderful people on this website my life began to get better.

I hope everything works out for you

best of luck

Ants

 

Thanks for that Ants - I appreciate it.

Like you I am grateful for all the support I have received from everyone on this forum and for all the information on the website.

I'm due have my biopsy on the 5th June and get my results on the 12th June.

I'm hoping for a clear result where the decision with regards to the next step will also be clear as I'm not the greatest at making decisions at the best of times and it is all the uncertainty that has played with my mind and got me down.

All the best to you and I hope that things continue to get better for you.

 

User
Posted 19 May 2018 at 18:05

Originally Posted by: Online Community Member

I don't think there are any easy answers here, Lazarus. I have no symptoms, but because I'm 55 my GP suggested a PSA test which came back with a result of 31, which is definitely "cause for concern". I've had an MRI scan (which, interestingly, showed no prostate abnormality) and I've just had a biopsy, the result of which I'll get in a little under two weeks. Even if it does all come back negative, I'll still be happy that I've had the investigations done, and if (as seems much more likely) the result is positive, I'll be even more happy that I know about it and can get the appropriate treatment. I'm definitely not a supporter of the "ignorance is bliss" point of view, and I really wish that there was a national screening programme in place. The way things are now, an awful lot of men only get diagnosed with prostate cancer when it's reached an advanced stage and symptoms show up!

Chris

 

 

Thanks Chris

I believe there are two problems with a national screening service for prostate cancer

1. The only currently available screening test is the PSA blood test that is in itself deemed to be too unreliable to be used for a national screening program.

2. In the recent Cancer Research UK 10 year study in which a group of men over 50 with no symptoms were invited to take a PSA test and were compared to a group of men over 50 with no symptoms who were not invited to take a PSA test concluded that the fatality rate was the same in both groups due to missed high grade cancers - showing there was no overall advantage in testing men over 50 with no symptoms. 

Why a one-off PSA test for prostate cancer is doing men more harm than good: 

http://scienceblog.cancerresearchuk.org/2018/03/06/why-a-one-off-psa-test-for-prostate-cancer-is-doing-men-more-harm-than-good/

 

Edited by member 19 May 2018 at 18:11  | Reason: Not specified

User
Posted 19 May 2018 at 19:00

Hi Lazarus,

I understand and share your anxiety, been there done that. And I hope that your results are clear for you.

Your paragraph 2 is only worth nothing for the men in that test sample.

Hopefully No Man Over 50 With No Symptoms Reading That Will Be Deterred From Having A Test

What would you say to those men over 50, without symptoms, diagnosed, who's lives are saved and lengthened as a result of a PSA test?

Any man, or any partner of any man reading this should consider whether having a PSA test is for them or not, not based on some random sample of others.

Do let us know your results. Have a great weekend.

dave

User
Posted 19 May 2018 at 19:15

The point is, Lazarus, that if a man is diagnosed with prostate cancer, he can then make an informed decision whether or not to have treatment, and a high PSA score can often lead to such a diagnosis. Without a test, he may very well be unaware that he has cancer, and that choice is denied him. Don't confuse testing with treatment!

Best wishes,

Chris

User
Posted 19 May 2018 at 23:22

Unfortunately, the tests done for PCa are not always definitive, even for the professionals so the necessity for needing radical treatment it is not always clear. Also, whatever statistics that are put forward in one study may be contradicted by another. See here where it is says PSA Tests Save Lives After All. https://www.thespec.com/news-story/7537342-psa-screening-for-prostate-cancer-saves-lives-after-all-study-says/

My take on this is that in some cases PSA tests leading to radical treatment provides at the very least more remaining time than in a man with a similar diagnosis who decides not to have treatment or does not know he has PCa or it's extent. However, due to uncertainty of the way PCa can develop, this means that some men whose PCa would not become a problem are treated. It's a considered risk on the part of the individual. Also to be considered is that whether in reality needed or not, in either case the treatment may have varying adverse side effects and where really needed may call for further treatment(s).

Barry
User
Posted 20 May 2018 at 15:30

I am in the pub with a friend who is 68 whose father died of prostate cancer who has never had a PSA test or a DRE!

Another friend is here aged 75 with a PSA of 2.2, and recently was offered a DRE and a lump was found. Three weeks later, he has had an MRI, biopsy and cancer diagnosis.

They like me, are asymptomatic

Edited by member 21 May 2018 at 13:17  | Reason: Not specified

User
Posted 20 May 2018 at 17:18

I think it is Chris J whose brother has never been tested despite being a doctor and having a brother diagnosed in his 40s.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 May 2018 at 09:48

I'm just hoping that when I get the results of the biopsy on June 12th that they are unambiguous.
If the biopsy results are ambiguous I'm not going to have treatment right away.
I've waited a long time for summer and I'm not about to spend it having cancer treatment unless I know I really have to.
Therefore if I can delay treatment and adopt the wait and test regularly approach that's what I shall do.

What the Cancer Research study tells us that overall it makes no difference to the overall positive outcomes if men over 50 with no symptoms are invited to take a PSA test or not and screening of all men over 50 would lead to significant numbers of men undergoing unnescessary treatment for a prostate cancer that would never have harmed them.
Of course the individual's choice to have a PSA blood test is just that - the individuals choice.
I was invited to to take a PSA blood test after telling GP vague symptoms that I worried could be cancer.
The PSA test came back at 6.5 and the next one at 4.5 (as I'm 52 anything above 3 is considered to be a raised level)
As a consequence I have had an MRI scan that shows no evidence of high grade cancer there is a lesion that could be cancer hence why the MRI scan was graded as 3 and transperineal template biopsy was recommended and scheduled for June 5th.
I won't know where I stand until I am given the results of the biopsy on the 12th June but I do think I heard is that a MRI scan followed by a template biopsy is 93% accurate when it comes to finding the cancer if there is any.

Edited by member 21 May 2018 at 09:52  | Reason: Not specified

User
Posted 21 May 2018 at 20:10

When John was diagnosed, the surgeon advised that we take a short pause, go off on a holiday and do lots of 'what couples do." Unfortunately John was in a dreadful hurry to get it cut out and did not heed the advice, having his RP 26 days later.

In the horrible months and years after, we both said how nice it would have been to have had a lovely holiday and some happy things to look back on when we were struggling with the new normal.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 May 2018 at 20:50

That’s a nice post Lyn in a way. I spent so much time doing what couples do , that I missed the boat essentially. Epic fail surgery , and now after taking over 2 years to recover , I’m still preferring doing what couples do ! Maybe John was right as you are still firmly in the long term remission camp and enjoying life more than some people waiting on every appointment. Oh , and dancing a lot :-)) x

User
Posted 21 May 2018 at 21:19

Not much dancing going on at the minute - his two new knees are cramping my style rather a lot :-(

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 May 2018 at 22:00

Ouch very much. I’m going for a drain and cortisone tomorrow. Have had to quit HCA as pain too much tbh. Seriously making me reconsider future stuff. I can barely walk the dogs at still 50 😬

User
Posted 21 May 2018 at 22:10

Originally Posted by: Online Community Member

I'm just hoping that when I get the results of the biopsy on June 12th that they are unambiguous.
If the biopsy results are ambiguous I'm not going to have treatment right away.
I've waited a long time for summer and I'm not about to spend it having cancer treatment unless I know I really have to.
Therefore if I can delay treatment and adopt the wait and test regularly approach that's what I shall do.

What the Cancer Research study tells us that overall it makes no difference to the overall positive outcomes if men over 50 with no symptoms are invited to take a PSA test or not and screening of all men over 50 would lead to significant numbers of men undergoing unnescessary treatment for a prostate cancer that would never have harmed them.
Of course the individual's choice to have a PSA blood test is just that - the individuals choice.
I was invited to to take a PSA blood test after telling GP vague symptoms that I worried could be cancer.
The PSA test came back at 6.5 and the next one at 4.5 (as I'm 52 anything above 3 is considered to be a raised level)
As a consequence I have had an MRI scan that shows no evidence of high grade cancer there is a lesion that could be cancer hence why the MRI scan was graded as 3 and transperineal template biopsy was recommended and scheduled for June 5th.
I won't know where I stand until I am given the results of the biopsy on the 12th June but I do think I heard is that a MRI scan followed by a template biopsy is 93% accurate when it comes to finding the cancer if there is any.

 

I wish you well for your biopsy.

 

So much of your post above is inaccurate and misleading and may lead to men not seeking appropriate examination or treatment.  

Let us all hope that it does not cause anyone life changing or life ending consequences.

dave

User
Posted 21 May 2018 at 23:12

What bit of it is inaccurate or misleading CB? It has been quoted very precisely and, whether you like it or not, is exactly what the researchers concluded and NICE have positioned themselves on.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 22 May 2018 at 19:31

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member

I'm just hoping that when I get the results of the biopsy on June 12th that they are unambiguous.
If the biopsy results are ambiguous I'm not going to have treatment right away.
I've waited a long time for summer and I'm not about to spend it having cancer treatment unless I know I really have to.
Therefore if I can delay treatment and adopt the wait and test regularly approach that's what I shall do.

What the Cancer Research study tells us that overall it makes no difference to the overall positive outcomes if men over 50 with no symptoms are invited to take a PSA test or not and screening of all men over 50 would lead to significant numbers of men undergoing unnescessary treatment for a prostate cancer that would never have harmed them.
Of course the individual's choice to have a PSA blood test is just that - the individuals choice.
I was invited to to take a PSA blood test after telling GP vague symptoms that I worried could be cancer.
The PSA test came back at 6.5 and the next one at 4.5 (as I'm 52 anything above 3 is considered to be a raised level)
As a consequence I have had an MRI scan that shows no evidence of high grade cancer there is a lesion that could be cancer hence why the MRI scan was graded as 3 and transperineal template biopsy was recommended and scheduled for June 5th.
I won't know where I stand until I am given the results of the biopsy on the 12th June but I do think I heard is that a MRI scan followed by a template biopsy is 93% accurate when it comes to finding the cancer if there is any.

 

I wish you well for your biopsy.

 

So much of your post above is inaccurate and misleading and may lead to men not seeking appropriate examination or treatment.  

Let us all hope that it does not cause anyone life changing or life ending consequences.

dave

Thanks for your well wishes dave.

As for you saying my post is inaccurate or misleading? Well you can read the results of the 10 year Cancer Research UK study yourself here:

Why a one-off PSA test for prostate cancer is doing men more harm than good 

Edited by member 22 May 2018 at 19:33  | Reason: Not specified

User
Posted 22 May 2018 at 22:16

Hi Lazarus, Lynne

Actually, what I like or not is immaterial.

A one off test is of little use, thats why maybe men should consider a series of tests to establish "our" level. You're going to have a series of tests, excellent.

Biopsy is not conclusive, as we know. PSA test is a guide, not infallible. MRI is another guide, with potential for misreading as I and others here know.

But, it's all we've got at the moment, so we test and we hope. Thankfully advances are being made all the time.

All the best.

dave

 
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